Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun;5(2):339-48.
doi: 10.1086/681226.

Trends in pediatric pulmonary hypertension-related hospitalizations in the United States from 2000-2009

David B Frank  1 , Matthew A Crystal  2 , David L S Morales  3 , Ken Gerald  4 , Brian D Hanna  1 , George B Mallory Jr  5 , Joseph W Rossano  1
Affiliations

Trends in pediatric pulmonary hypertension-related hospitalizations in the United States from 2000-2009

David B Frank et al. Pulm Circ. 2015 Jun.

Abstract

There are few data on the epidemiology of pulmonary hypertension (PH)-related hospitalizations in children in the United States. Our aim was to determine hospital mortality, length of hospitalization, and hospital charges pertaining to PH-related hospitalizations and also the effects of codiagnoses and comorbidities. A retrospective review of the Kids' Inpatient Database during the years 2000, 2003, 2006, and 2009 was analyzed for patients ≤20 years of age with a diagnosis of PH by ICD-9 (International Classification of Diseases, Ninth Revision) codes, along with associated diagnoses and comorbidities. Descriptive statistics, including Rao-Scott χ(2), ANOVA, and logistic regression models, were utilized on weighted values with survey analysis procedures. The number of PH-related hospital admissions is rising, from an estimated 7,331 (95% confidence interval [CI]: 5,556-9,106) in 2000 to 10,792 (95% CI: 8,568-13,016) in 2009. While infant age and congenital heart disease were most commonly associated with PH-related hospitalizations, they were not associated with mortality. Overall mortality for PH-related hospitalizations was greater than that for hospitalizations not associated with PH, 5.7% versus 0.4% (odds ratio: 16.22 [95% CI: 14.78%-17.8%], P < 0.001), but mortality is decreasing over time. Sepsis, respiratory failure, acute renal failure, hepatic insufficiency, arrhythmias, and the use of extracorporeal membrane oxygenation are associated with mortality. The number of PH-related hospitalizations is increasing in the United States. The demographics of PH in this study are evolving. Despite the increasing prevalence, mortality is improving.

Keywords: epidemiology; pediatrics; pulmonary hypertension; survival.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A, Mean length of stay, in days, for pulmonary hypertension (PH)–related hospitalizations in children across the years studied; P < 0.001 from ANOVA across years. B, Associated diagnoses’ effect on mean length of stay, in days, for pulmonary hypertension–related hospitalizations. An asterisk indicates P < 0.05 for diagnoses associated with a change in length of stay compared to non–pulmonary hypertension–related hospitalizations. BPD: bronchopulmonary dysplasia; CDH: congenital diaphragmatic hernia; CHD: congenital heart disease; ECMO: extracorporeal membrane oxygenation; SLE/CTD: systemic lupus erythematosus/connective-tissue disorder.
Figure 2
Figure 2
A, Hospital mortality, in percent, for pulmonary hypertension–related hospitalization in children across the years studied; P < 0.001 from ANOVA across years. B, Association of codiagnoses and mortality. An asterisk indicates P < 0.05 for factors significantly associated with increased or decreased mortality. BPD: bronchopulmonary dysplasia; CDH: congenital diaphragmatic hernia; CHD: congenital heart disease; ECMO: extracorporeal membrane oxygenation; SLE/CTD: systemic lupus erythematosus/connective tissue disorder.
Figure 3
Figure 3
A, Hospital charges, in US dollars, for pulmonary hypertension–related hospitalizations in children across the years studied; P < 0.001 from ANOVA across years. B, Associated diagnoses effect on hospital charges for pulmonary hypertension–related hospitalizations. An asterisk indicates P < 0.05 for diagnoses associated with a change in hospital charges compared to non–pulmonary hypertension–related hospitalizations. BPD: bronchopulmonary dysplasia; CDH: congenital diaphragmatic hernia; CHD: congenital heart disease; ECMO: extracorporeal membrane oxygenation; SLE/CTD: systemic lupus erythematosus/connective tissue disorder.
See this image and copyright information in PMC

References

    1. Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, Gomez Sanchez MA, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013;62(25 suppl.):D34–D41. - PubMed
    1. Barst RJ, McGoon MD, Elliott CG, Foreman AJ, Miller DP, Ivy DD. Survival in childhood pulmonary arterial hypertension: insights from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management. Circulation 2012;125(1):113–122. - PubMed
    1. Galiè N, Hoeper MM, Humbert M, Torbicki A, Vachiéry JL, Barbera JA, Beghetti M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 2009;30(20):2493–2537. - PubMed
    1. Berger RM, Beghetti M, Humpl T, Raskob GE, Ivy DD, Jing ZC, Bonnet D, Schulze-Neick I, Barst RJ. Clinical features of paediatric pulmonary hypertension: a registry study. Lancet 2012;379(9815):537–546. - PMC - PubMed
    1. Fraisse A, Jaïs X, Schleich JM, Filippo S, Maragnès P, Beghetti M, Gressin V, et al. Characteristics and prospective 2-year follow-up of children with pulmonary arterial hypertension in France. Arch Cardiovasc Dis 2010;103(2):66–74. - PubMed

LinkOut - more resources